| NPI | 1629246087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE IRENE STRAKOSCH Registered Nurse 631-255-3677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 588747-1) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |